<cfparam name="view" type="string" default="step1" />
<cfparam name="action" type="string" default="" />
<cfparam name="workshopID" type="numeric" default="0" />
<cfparam name="mode" type="string" default="live" />
<cfparam name="error" type="string" default="" />
<!--- <cfset pbsRegions = "1,2,3,5,12" /> --->
<cfswitch expression="#action#">
	<cfcase value="packEvaluation">
		<cfset evaluationStruct = StructNew() />
		<cfloop index="key" list="#StructKeyList(form)#">
			<cfset evaluationStruct[key] = HTMLEditFormat(form[key]) />
		</cfloop>
		<cfwddx action="cfml2wddx" input="#evaluationStruct#" output="evaluationWDDX" />
 		<cfset view = "step2" />
	</cfcase>
	<cfcase value="saveStudentEvaluation">
		<cftry>
			<cfif mode eq "live">
				<cfwddx action="wddx2cfml" input="#evaluationWDDX#" output="evaluation" />
			<cfelse>
				<cfwddx action="wddx2cfml" input="#evaluationWDDX#" output="evaluationPractice" />
			</cfif>
			<cfscript>
				if (mode eq "live") {
					studentGateway = new assets.calgrants.com.gateway.StudentGateway();
					student = studentGateway.save(argumentCollection = form);
					evaluation.Student_ID = student.getStudent_ID();
					evaluationGateway = new assets.calgrants.com.gateway.EvaluationGateway();
					evaluation = evaluationGateway.save(argumentCollection = evaluation);
				} else {
					studentPracticeGateway = new assets.calgrants.com.gateway.StudentPracticeGateway();
					form.Student_Practice_ID = 0;
					studentPractice = studentPracticeGateway.save(argumentCollection = form);
					evaluationPractice.Evaluation_Practice_ID = 0;
					evaluationPractice.Student_Practice_ID = studentPractice.getStudent_Practice_ID();
					evaluationPracticeGateway = new assets.calgrants.com.gateway.EvaluationPracticeGateway();
					evaluationPractice = evaluationPracticeGateway.save(argumentCollection = evaluationPractice);	
				}
			</cfscript>
			<cfset view = "thankYou" />
			<cfcatch type="any">
				<cfdump var="#cfcatch#">
				<cfabort>
			</cfcatch>				
		</cftry>
	</cfcase>
</cfswitch>
<cfscript>
	workshopGateway = new assets.calgrants.com.gateway.WorkshopGateway();
	workshop = workshopGateway.get(Workshop_ID = workshopID);
	siteGateway = new assets.calgrants.com.gateway.SiteGateway();
	site = siteGateway.get(Site_ID = workshop.getSite_ID());
	countyGateway = new assets.calgrants.com.gateway.CountyGateway();
	county = countyGateway.get(County_ID = site.getCounty_ID());
</cfscript>
<!DOCTYPE html>
<html>
<head>
	<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
	<title>Cash for College Workshop Wrapper</title>
	<meta name="viewport" content="width=device-width, initial-scale=1.0">
	<meta name="description" content="Cash for College Workshop Management System for Administrators">
	<meta name="author" content="Syntric">
	<cfoutput>
		<script src="#request.pathToJQuery#" type="text/javascript"></script>
		<script src="#request.pathToJQueryUI#" type="text/javascript"></script>
		<script src="#request.pathToBootstrap#" type="text/javascript"></script>
		<link href="#request.pathToBootstrapCSS#" rel="stylesheet" />
		<link href="#request.pathToUI#/common.css" rel="stylesheet" />
		<link href="https://fonts.googleapis.com/css?family=Open+Sans:300,400,600,700,800" rel="stylesheet" type="text/css" />
	</cfoutput>
	<cfif view eq "step1">
		<script type="text/javascript">
			toggleOther = function(el, otherEl) {
				if ($(el).is(":checked")) {
					$("#" + otherEl).val("");
					$("#" + otherEl).show();
				} else {
					$("#" + otherEl).val("");
					$("#" + otherEl).hide();	
				}
			}
			closeOther = function(otherEl) {
				$("#" + otherEl).val("");
				$("#" + otherEl).hide();
			}
			adjust15 = function() {
				if ($("#q15-1").is(":checked")) {
					$(".q16").attr("checked", false).attr("disabled", true);
					$(".q17").attr("checked", false).attr("disabled", true);
					$("#q16").attr("checked", false).css("color", "silver");
					$("#q17").attr("checked", false).css("color", "silver");
				}
				if ($("#q15-2").is(":checked") || $("#q15-3").is(":checked")) {
					$(".q16").removeAttr("disabled");
					$(".q17").removeAttr("disabled");
					$("#q16").css("color", "black");
					$("#q17").css("color", "black");
				}
			}
			validate = function() {
				var errors = "";
				var valid = true;
				var q7Valid = false;
				$.each($(".q7"), function(i, v) {
					if ($(v).is(":checked")) {
						q7Valid = true;
					}
				})
				if (!q7Valid) {
					errors += "An answer for question 7 is required\n";
				}
				valid = q7Valid;
				if ($("#q9OtherCheckbox").is(":checked") && $("#q9Other").val().length == 0) {
					errors += "An answer for question 9 \"Other\" is required\n";
					valid = false;
				}
				if ($("#q12OtherCheckbox").is(":checked") && $("#q12Other").val().length == 0) {
					errors += "An answer for question 12 \"Other\" is required\n";
					valid = false;
				}
				if ($("#q13OtherCheckbox").is(":checked") && $("#q13Other").val().length == 0) {
					errors += "An answer for question 13 \"Yes\" is required\n";
					valid = false;	
				}
				if ($("#q14OtherCheckbox").is(":checked") && $("#q14Other").val().length == 0) {
					errors += "An answer for question 14 \"Other\" is required\n";
					valid = false;
				}
				if ($("#q16OtherCheckbox").is(":checked") && $("#q16Other").val().length == 0) {
					errors += "An answer for question 16 \"Other\" is required\n";
					valid = false;
				}
				if ($("#q18OtherCheckbox").is(":checked") && $("#q18Other").val().length == 0) {
					errors += "An answer for question 18 \"Other\" is required\n";
					valid = false;
				}
				if (!valid) {
					alert(errors);
				}
				return valid;
			}
		</script>
	<cfelseif view eq "step2">
		<script type="text/javascript">
		<!--
			validate = function() {
				var errors = "";
				var valid = true;
				if ($("#ssnCode1").is(":checked") && trim($("#ssn").val()).length < 4) {
					valid = false;
					errors += "Enter the last 4 digits of your SSN or select another value for Social Security Number\n";
				} else if ($("#ssnCode4").is(":checked") && trim($("#ssn").val()).length < 4) {
					valid = false;
					errors += "Enter the last 4 digits of your DACA SSN or select another value for Social Security Number\n";
				}
				if (Date.parse($("#dob").val()) < Date.parse("1/1/1940")) {
					valid = false;
					errors += "The DOB entered is out of range";
				}
				if (!valid) {
					alert(errors);
				}
				return valid;
			}
			checkSSN = function() {
				if ($("#ssnCode1").is(":checked")) {
					$("#ssn").removeAttr("disabled");
				} else if ($("#ssnCode2").is(":checked")) {
					$("#ssn").val("").attr("disabled", true);
				} else if ($("#ssnCode3").is(":checked")) {
					$("#ssn").val("").attr("disabled", true);
				} else if ($("#ssnCode4").is(":checked")) {
					$("#ssn").removeAttr("disabled");
				}
			}
			trim = function(str) {
				var ret = "";
				ret = str.replace(/^\s*/,"");
				ret = ret.replace(/\s*$/,"");
				return ret;
			}
		//-->
		</script>
		<style type="text/css">
			.required {
				color: #ff3300;
			}
			label {
				font-weight: bold;
			}
		</style>
	</cfif>
</head>
<body>
	<div class="container-fluid">
		<div class="row-fluid">
			<div class="span12">
				<table border="0" cellpadding="0" cellspacing="0">
					<tr valign="bottom">
						<td style="padding-right: 20px;">
							<img src="images/Cash_for_College_logo.gif" width="204" height="54">
						</td>
						<cfif mode eq "practice">
							<td style="padding-bottom: 5px;">
								<span style="font-size: 2em; font-weight: bold; color: red;">Practice Mode</span>
							</td>
						</cfif>
					</tr>
					<tr>
						<td colspan="2">&nbsp;<br /></td>
					</tr>
				</table>
			</div>
		</div>
		<cfswitch expression="#view#">
			<cfcase value="step1">
				<div class="row-fluid">
					<div class="span12">
						<h2>Exit Survey</h2>
						<p><strong>Part 1 of 2</strong></p>
						<p>We want to hear from you! Tell us about your experience today on this exit survey.</p>
						<!--- <cfif not sReg>
							<p>PLUS, HIGH SCHOOL SENIORS: complete this survey, apply for a Cal Grant by March 2, and you could cash in on an extra $1,000 scholarship! Seniors who may qualify for AB 540 are eligible for this scholarship, too!</p>
						</cfif> --->
					</div>
				</div>
				<div class="row-fluid">
					<div class="span12">
						<cfform id="evaluationForm" name="evaluationForm" action="#script_name#" method="post" onsubmit="return validate();">
							<cfinput type="hidden" name="workshopID" value="#workshop.getWorkshop_ID()#">
							<cfinput type="hidden" name="mode" value="#mode#" />
							<cfinput type="hidden" name="Evaluation_ID" value="0" />
							<cfinput type="hidden" name="Student_ID" value="0" />
							<cfinput type="hidden" name="action" value="packEvaluation" />
							<div class="q">
								<a name="q1"></a>
								<h5>1. How would you rate this workshop overall?</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" name="q1" value="1">
										Excellent
									</label>
									<label class="radio">
										<cfinput type="radio" name="q1" value="2">
										Good
									</label>
									<label class="radio">
										<cfinput type="radio" name="q1" value="3">
										Fair
									</label>
									<label class="radio">
										<cfinput type="radio" name="q1" value="4">
										Poor
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q2"></a>
								<h5>2. Before you heard about this workshop, did you know how to apply for financial aid?</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" name="q2" value="1"> 
										Yes
									</label>
									<label class="radio">
										<cfinput type="radio" name="q2" value="2"> 
										No
									</label>
									<label class="radio">
										<cfinput type="radio" name="q2" value="3"> 
										A little, but not all I needed to know
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q3"></a>
								<h5>3. Could you have completed the FAFSA on your own, without the help provided by a Cash for College workshop?</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" name="q3" value="1"> 
										Yes
									</label>
									<label class="radio">
										<cfinput type="radio" name="q3" value="2"> 
										No
									</label>
									<label class="radio">
										<cfinput type="radio" name="q3" value="3"> 
										Probably, but not as well
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q4"></a>
								<h5>4. Was the help you received worth the effort of attending?</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" name="q4" value="1"> 
										Yes
									</label>
									<label class="radio">
										<cfinput type="radio" name="q4" value="2"> 
										No
									</label>
									<label class="radio">
										<cfinput type="radio" name="q4" value="3"> 
										Not sure
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q5"></a>
								<h5>5. Will you be the first member of your family to attend college?</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" name="q5" value="1"> 
										Yes
									</label>
									<label class="radio">
										<cfinput type="radio" name="q5" value="2"> 
										No
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q6"></a>
								<h5>6. Highest level of education your parents completed</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" name="q6" value="1"> 
										Didn't complete high school
									</label>
									<label class="radio">
										<cfinput type="radio" name="q6" value="2"> 
										High School or GED
									</label>
									<label class="radio">
										<cfinput type="radio" name="q6" value="3"> 
										Some college but no degree
									</label>
									<label class="radio">
										<cfinput type="radio" name="q6" value="4"> 
										Vocational certificate
									</label>
									<label class="radio">
										<cfinput type="radio" name="q6" value="5"> 
										2-year  degree
									</label>
									<label class="radio">
										<cfinput type="radio" name="q6" value="6"> 
										4-year degree or higher
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q7"></a>
								<h5>7. Are you a high school senior?</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" name="q7" class="q7" value="1"> 
										Yes
									</label>
									<label class="radio">
										<cfinput type="radio" name="q7" class="q7" value="2"> 
										No
									</label>
									<label class="radio">
										<cfinput type="radio" name="q7" class="q7" value="3"> 
										Family member of senior
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q8"></a>
								<h5>8. What high school do you attend (name of school and city)?</h5>
								<blockquote>
									<cfinput type="text" name="q8" maxlength="200" value="" class="disableAutoComplete">
								</blockquote>
							</div>
							<div class="q">
								<a name="q9"></a>
								<h5>9. Are you member of a social networking site?  (Mark all that apply)</h5>
								<blockquote>
									<label class="checkbox">
										<cfinput type="checkbox" name="q9" value="1"> 
										Facebook
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q9" value="5">
										Twitter
									</label>
									<label class="checkbox">
										<cfinput id="q9OtherCheckbox" type="checkbox" name="q9" value="3" onClick="toggleOther(this, 'q9Other');">
										Other 
									</label>
									<cfinput id="q9Other" type="text" placeholder="Enter other site(s)" maxlength="200" name="q9_other" class="disableAutoComplete" style="display: none;">
									<label class="checkbox">
										<cfinput type="checkbox" name="q9" value="4">
										None
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q10"></a>
								<h5>10. Did you attend with your parent or guardian today?</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" name="q10" value="1"> 
										Yes
									</label>
									<label class="radio">
										<cfinput type="radio" name="q10" value="2"> 
										No
									</label>
								</blockquote>
							</div>
							<!--- 
									Note that the following question appears as question #11 to the user, however the data element is q21.
									Additionally note that every question following this one is shifted where the number appearing to the the user is one more than the data element name (eg #12 = q11)
							--->
							<div class="q">
								<a name="q21"></a>
								<h5>11. At any time since you turned age 13, were both of your parents deceased, were you in foster care or were you a dependent ward of the court?</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" name="q21" value="1"> 
										Yes
									</label>
									<label class="radio">
										<cfinput type="radio" name="q21" value="2"> 
										No
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q11"></a>
								<h5>12. What is your gender?</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" name="q11" value="1"> 
										Male
									</label>
									<label class="radio">
										<cfinput type="radio" name="q11" value="2"> 
										Female
									</label>
									<label class="radio">
										<cfinput type="radio" name="q11" value="3"> 
										Decline to answer
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q12"></a>
								<h5>13. What is your race/ethnicity? (Mark all that apply)</h5>
								<blockquote>
									<label class="checkbox">
										<cfinput type="checkbox" name="q12" value="1"> 
										American Indian or Alaskan Native
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q12" value="2"> 
										Asian
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q12" value="3"> 
										Black/African American
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q12" value="4"> 
										Hispanic/Latino
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q12" value="5"> 
										Native Hawaiian or other Pacific Islander
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q12" value="6"> 
										White
									</label>
									<label class="checkbox">
										<cfinput id="q12OtherCheckbox" type="checkbox" name="q12" value="7" onClick="toggleOther(this, 'q12Other');">
										Other 
									</label>
									<cfinput id="q12Other" placeholder="Enter other race/ethnicity" type="text" maxlength="200" name="q12_other" class="disableAutoComplete" style="display: none;">
									<label class="checkbox">
										<cfinput type="checkbox" name="q12" value="8"> 
										Decline to Answer
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q13"></a>
								<h5>14. Do you usually speak a language other than English at home?</h5>
								<blockquote>
									<label class="radio">
										<cfinput id="q13OtherCheckbox" type="radio" name="q13" value="1" onClick="toggleOther(this, 'q13Other');">
										Yes 
									</label>
									<cfinput id="q13Other" type="text" placeholder="Enter other language" maxlength="200" name="q13_Other" class="disableAutoComplete" style="display: none;">
									<label class="radio">
										<cfinput type="radio" name="q13" value="2" onClick="closeOther('q13Other');"> 
										No
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q14"></a>
								<h5>15. How did you hear about this Cash for College workshop? (Mark all that apply)</h5>
								<blockquote>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="1"> 
										School flyer/poster
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="2"> 
										School counselor
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="3"> 
										Teachers/school staff
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="4"> 
										Radio
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="5"> 
										Newspaper
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="6"> 
										Website/e-mail
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="7"> 
										Mailing
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="8"> 
										Phone call
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="9"> 
										Friend/classmate
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="10"> 
										Family
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="11"> 
										Community organization
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="12"> 
										Church
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="13"> 
										Cal-SOAP event/staff
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="15"> 
										Facebook or Twitter
									</label>
									<label class="checkbox">
										<cfinput id="q14OtherCheckbox" type="checkbox" name="q14" value="14" onClick="toggleOther(this, 'q14Other');">
										Other
									</label>
									<cfinput id="q14Other" placeholder="Enter other method" type="text" maxlength="200" name="q14_other" class="disableAutoComplete" style="display: none;">
								</blockquote>
							</div>
							<div class="q">
								<a name="q15"></a>
								<h5>16. Did you finish your FAFSA or CA Dream Act application today?</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" id="q15-1" name="q15" value="1" onClick="adjust15(this);"> 
										Yes (skip to Question 19)
									</label>
									<label class="radio">
										<cfinput type="radio" id="q15-2" name="q15" value="2" onClick="adjust15(this);"> 
										Some, not all
									</label>
									<label class="radio">
										<cfinput type="radio" id="q15-3" name="q15" value="3" onClick="adjust15(this);"> 
										No, none
									</label>
									<label class="radio">
										<cfinput type="radio" id="q15-4" name="q15" value="4" onClick="adjust15(this);"> 
										No, already done
									</label>
								</blockquote>
							</div>
							<div id="q16" class="q" style="color: silver;">
								<a name="q16"></a>
								<h5>17. If you didn't finish your FAFSA or CA Dream Act application today, please tell us why: (Mark all that apply)</h5>
								<blockquote>
									<label class="checkbox">
										<cfinput type="checkbox" name="q16" value="1" class="q16" disabled>
										Don't have taxes complete
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q16" value="2" class="q16" disabled>
										Don't have financial info
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q16" value="3" class="q16" disabled>
										Computer problems
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q16" value="4" class="q16" disabled>
										Will submit later
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q16" value="5" class="q16" disabled>
										Needed CA Dream Act help
									</label>
									<label class="checkbox">
										<cfinput id="q16OtherCheckbox" type="checkbox" name="q16" value="6" class="q16" disabled onClick="toggleOther(this, 'q16Other');">
										Other 
									</label>
									<cfinput id="q16Other" placeholder="Enter other reason" type="text" maxlength="200" name="q16_other" class="q16 disableAutoComplete" style="display: none;">
								</blockquote>
							</div>
							<div id="q17" class="q" style="color: silver;">
								<a name="q17"></a>
								<h5>18. Would you like more help to complete your application?</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" name="q17" value="1" class="q17" disabled>
										Yes
									</label>
									<label class="radio">
										<cfinput type="radio" name="q17" value="2" class="q17" disabled>
										Maybe
									</label>
									<label class="radio">
										<cfinput type="radio" name="q17" value="3" class="q17" disabled>
										No
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q18"></a>
								<h5>19. How could this workshop be improved? (Mark all that apply)</h5>
								<blockquote>
									<label class="checkbox">
										<cfinput type="checkbox" name="q18" value="1"> 
										No improvement needed
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q18" value="2"> 
										More one-to-one help
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q18" value="3"> 
										More translators
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q18" value="4"> 
										Explain in more detail
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q18" value="5"> 
										Session too long
									</label>
									<label class="checkbox">
										<cfinput id="q18OtherCheckbox" type="checkbox" name="q18" value="6" onClick="toggleOther(this, 'q18Other');">
										Other<br />
									</label>
									<cfinput id="q18Other" placeholder="Enter other reason" type="text" maxlength="200" name="q18_other" class="disableAutoComplete" style="display: none;">
								</blockquote>
							</div>
							<div class="q">
								<a name="q19"></a>
								<h5>20. Did the Cash for College scholarship motivate you to attend today?</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" name="q19" value="1"> 
										Yes, definitely motivated me
									</label>
									<label class="radio">
										<cfinput type="radio" name="q19" value="2"> 
										Motivated me a little
									</label>
									<label class="radio">
										<cfinput type="radio" name="q19" value="3"> 
										Didn't motivate me at all
									</label>
									<label class="radio">
										<cfinput type="radio" name="q19" value="4"> 
										Didn't know about it
									</label>
								</blockquote>
							</div>
							<!--- <div class="q">
								<a name="q1"></a>
								<h5>1. How would you rate this workshop overall?</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" name="q1" value="1">
										Excellent
									</label>
									<label class="radio">
										<cfinput type="radio" name="q1" value="2">
										Good
									</label>
									<label class="radio">
										<cfinput type="radio" name="q1" value="3">
										Fair
									</label>
									<label class="radio">
										<cfinput type="radio" name="q1" value="4">
										Poor
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q2"></a>
								<h5>2. Before you heard about this workshop, did you know how to apply for financial aid?</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" name="q2" value="1"> 
										Yes
									</label>
									<label class="radio">
										<cfinput type="radio" name="q2" value="2"> 
										No
									</label>
									<label class="radio">
										<cfinput type="radio" name="q2" value="3"> 
										A little, but not all I needed to know
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q3"></a>
								<h5>3. Could you have completed the FAFSA on your own, without the help provided by a Cash for College workshop?</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" name="q3" value="1"> 
										Yes
									</label>
									<label class="radio">
										<cfinput type="radio" name="q3" value="2"> 
										No
									</label>
									<label class="radio">
										<cfinput type="radio" name="q3" value="3"> 
										Probably, but not as well
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q4"></a>
								<h5>4. Was the help you received worth the effort of attending?</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" name="q4" value="1"> 
										Yes
									</label>
									<label class="radio">
										<cfinput type="radio" name="q4" value="2"> 
										No
									</label>
									<label class="radio">
										<cfinput type="radio" name="q4" value="3"> 
										Not sure
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q5"></a>
								<h5>5. Will you be the first member of your family to attend college?</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" name="q5" value="1"> 
										Yes
									</label>
									<label class="radio">
										<cfinput type="radio" name="q5" value="2"> 
										No
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q6"></a>
								<h5>6. Highest level of education your parent's completed</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" name="q6" value="1"> 
										Did not complete high school
									</label>
									<label class="radio">
										<cfinput type="radio" name="q6" value="2"> 
										High School or GED
									</label>
									<label class="radio">
										<cfinput type="radio" name="q6" value="3"> 
										Some college but no degree
									</label>
									<label class="radio">
										<cfinput type="radio" name="q6" value="4"> 
										Vocational certificate
									</label>
									<label class="radio">
										<cfinput type="radio" name="q6" value="5"> 
										2-year (associates) degree
									</label>
									<label class="radio">
										<cfinput type="radio" name="q6" value="6"> 
										4-year bachelor's degree or higher
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q7"></a>
								<h5>7. Are you a high school senior?</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" name="q7" class="q7" value="1"> 
										Yes
									</label>
									<label class="radio">
										<cfinput type="radio" name="q7" class="q7" value="2"> 
										No
									</label>
									<label class="radio">
										<cfinput type="radio" name="q7" class="q7" value="3"> 
										Family member of senior
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q8"></a>
								<h5>8. What high school do you attend (name of school and city)?</h5>
								<blockquote>
									<cfinput type="text" name="q8" maxlength="200" value="" class="disableAutoComplete">
								</blockquote>
							</div>
							<div class="q">
								<a name="q9"></a>
								<h5>9. Are you member of a social networking site?  (Mark all that apply)</h5>
								<blockquote>
									<label class="checkbox">
										<cfinput type="checkbox" name="q9" value="1"> 
										Facebook
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q9" value="5">
										Twitter
									</label>
									<label class="checkbox">
										<cfinput id="q9OtherCheckbox" type="checkbox" name="q9" value="3" onClick="toggleOther(this, 'q9Other');">
										Other 
									</label>
									<cfinput id="q9Other" type="text" placeholder="Enter other site(s)" maxlength="200" name="q9_other" class="disableAutoComplete" style="display: none;">
									<label class="checkbox">
										<cfinput type="checkbox" name="q9" value="4">
										None
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q10"></a>
								<h5>10. Did you attend with your parent or guardian today?</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" name="q10" value="1"> 
										Yes
									</label>
									<label class="radio">
										<cfinput type="radio" name="q10" value="2"> 
										No
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q11"></a>
								<h5>11. What is your gender?</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" name="q11" value="1"> 
										Male
									</label>
									<label class="radio">
										<cfinput type="radio" name="q11" value="2"> 
										Female
									</label>
									<label class="radio">
										<cfinput type="radio" name="q11" value="3"> 
										Decline to Answer
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q12"></a>
								<h5>12. What is your race/ethnicity? (Mark all that apply)</h5>
								<blockquote>
									<label class="checkbox">
										<cfinput type="checkbox" name="q12" value="1"> 
										American Indian or Alaskan Native
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q12" value="2"> 
										Asian
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q12" value="3"> 
										Black/African American
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q12" value="4"> 
										Hispanic/Latino
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q12" value="5"> 
										Native Hawaiian or other Pacific Islander
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q12" value="6"> 
										White
									</label>
									<label class="checkbox">
										<cfinput id="q12OtherCheckbox" type="checkbox" name="q12" value="7" onClick="toggleOther(this, 'q12Other');">
										Other 
									</label>
									<cfinput id="q12Other" placeholder="Enter other race/ethnicity" type="text" maxlength="200" name="q12_other" class="disableAutoComplete" style="display: none;">
									<label class="checkbox">
										<cfinput type="checkbox" name="q12" value="8"> 
										Decline to Answer
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q13"></a>
								<h5>13. Do you usually speak a language other than English at home?</h5>
								<blockquote>
									<label class="radio">
										<cfinput id="q13OtherCheckbox" type="radio" name="q13" value="1" onClick="toggleOther(this, 'q13Other');">
										Yes 
									</label>
									<cfinput id="q13Other" type="text" placeholder="Enter other language" maxlength="200" name="q13_Other" class="disableAutoComplete" style="display: none;">
									<label class="radio">
										<cfinput type="radio" name="q13" value="2" onClick="closeOther('q13Other');"> 
										No
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q14"></a>
								<h5>14. How did you hear about this Cash for College workshop? (Mark all that apply)</h5>
								<blockquote>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="1"> 
										School flyer/poster
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="2"> 
										School counselor
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="3"> 
										Teachers/school staff
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="4"> 
										Radio
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="5"> 
										Newspaper
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="6"> 
										Website/e-mail
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="7"> 
										Mailing
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="8"> 
										Phone call
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="9"> 
										Friend/classmate
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="10"> 
										Family
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="11"> 
										Community organization
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="12"> 
										Church
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="13"> 
										Cal-SOAP event/staff
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q14" value="15"> 
										Facebook or Twitter
									</label>
									<label class="checkbox">
										<cfinput id="q14OtherCheckbox" type="checkbox" name="q14" value="14" onClick="toggleOther(this, 'q14Other');">
										Other
									</label>
									<cfinput id="q14Other" placeholder="Enter other method" type="text" maxlength="200" name="q14_other" class="disableAutoComplete" style="display: none;">
								</blockquote>
							</div>
							<div class="q">
								<a name="q15"></a>
								<h5>15. Did you finish your FAFSA or CA Dream Act application today?</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" id="q15-1" name="q15" value="1" onClick="adjust15(this);"> 
										Yes (skip to Question 18)
									</label>
									<label class="radio">
										<cfinput type="radio" id="q15-2" name="q15" value="2" onClick="adjust15(this);"> 
										Some, not all
									</label>
									<label class="radio">
										<cfinput type="radio" id="q15-3" name="q15" value="3" onClick="adjust15(this);"> 
										No, none
									</label>
								</blockquote>
							</div>
							<div id="q16" class="q" style="color: silver;">
								<a name="q16"></a>
								<h5>16. If you didn't finish your FAFSA or CA Dream Act application today, please tell us why: (Mark all that apply)</h5>
								<blockquote>
									<label class="checkbox">
										<cfinput type="checkbox" name="q16" value="1" class="q16" disabled>
										Thought I had to have taxes completed
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q16" value="2" class="q16" disabled>
										Didn't bring enough financial info with me
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q16" value="3" class="q16" disabled>
										Technical problem with computer
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q16" value="4" class="q16" disabled>
										Will submit later on the Internet
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q16" value="5" class="q16" disabled>
										Asked for AB 540 help
									</label>
									<label class="checkbox">
										<cfinput id="q16OtherCheckbox" type="checkbox" name="q16" value="6" class="q16" disabled onClick="toggleOther(this, 'q16Other');">
										Other 
									</label>
									<cfinput id="q16Other" placeholder="Enter other reason" type="text" maxlength="200" name="q16_other" class="q16 disableAutoComplete" style="display: none;">
								</blockquote>
							</div>
							<div id="q17" class="q" style="color: silver;">
								<a name="q17"></a>
								<h5>17. Would you like more help to complete the FAFSA or CA Dream Act application?</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" name="q17" value="1" class="q17" disabled>
										Yes
									</label>
									<label class="radio">
										<cfinput type="radio" name="q17" value="2" class="q17" disabled>
										Maybe
									</label>
									<label class="radio">
										<cfinput type="radio" name="q17" value="3" class="q17" disabled>
										No
									</label>
								</blockquote>
							</div>
							<div class="q">
								<a name="q18"></a>
								<h5>18. How could this workshop be improved? (Mark all that apply)</h5>
								<blockquote>
									<label class="checkbox">
										<cfinput type="checkbox" name="q18" value="1"> 
										No improvement needed
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q18" value="2"> 
										More one-to-one help
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q18" value="3"> 
										More translators
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q18" value="4"> 
										Explain in more detail
									</label>
									<label class="checkbox">
										<cfinput type="checkbox" name="q18" value="5"> 
										Session too long
									</label>
									<label class="checkbox">
										<cfinput id="q18OtherCheckbox" type="checkbox" name="q18" value="6" onClick="toggleOther(this, 'q18Other');">
										Other<br />
									</label>
									<cfinput id="q18Other" placeholder="Enter other reason" type="text" maxlength="200" name="q18_other" class="disableAutoComplete" style="display: none;">
								</blockquote>
							</div>
							<div class="q">
								<a name="q19"></a>
								<h5>19. Did the extra $1,000 scholarship motivate you to attend today?</h5>
								<blockquote>
									<label class="radio">
										<cfinput type="radio" name="q19" value="1"> 
										Yes, definitely motivated me
									</label>
									<label class="radio">
										<cfinput type="radio" name="q19" value="2"> 
										Motivated me a little
									</label>
									<label class="radio">
										<cfinput type="radio" name="q19" value="3"> 
										Was going to attend; didn't motivate me to attend
									</label>
									<label class="radio">
										<cfinput type="radio" name="q19" value="4"> 
										Didn't know about it
									</label>
								</blockquote>
							</div> --->
							<div>
								<cfinput type="submit" name="submit" value="Continue" class="btn btn-primary btn-large">
							</div>
						</cfform>
					</div>
				</div>
			</cfcase>
			
			<cfcase value="step2">
				<cfscript>
					cityGateway = new assets.calgrants.com.gateway.CityGateway();
					qCities = cityGateway.query();
				</cfscript>
				<cfquery name="cities" dbtype="query">
					select distinct city from qCities order by city
				</cfquery>
				<cfset studyRegion = false />
				<div class="row-fluid">
					<div class="span12">
						<h2>Exit Survey</h2>
						<p><strong>Part 2 of 2</strong></p>
						<p>By providing your contact information in the form below, high school, college and Cash for College representatives may contact you to help you complete the financial aid process, or to help evaluate the workshop program. Your information is kept private and may only be shared with the National Student Clearinghouse for evaluation purposes, to verify enrollment at higher education institutions. Your information will not be shared with any unauthorized persons or organizations.</p>
						<p><strong>High school seniors: This is your official scholarship entry form</strong></p>
						<p>By attending a Cash for College workshop and completing this exit survey, high school seniors could qualify for a $1,000 scholarship provided by ECMC. At least one qualifying student from each qualifying workshop who has completed the 2014-15 FAFSA or 2014-15 CA Dream Act Application, and submitted a verified Cal Grant GPA by the March 2 Cal Grant deadline will be randomly selected to receive a scholarship. At least one scholarship per qualifying workshop will be awarded in May 2014. To claim the scholarship, recipients must attend a qualifying, accredited, 2-year or 4-year degree granting institution of their choice in the Fall of 2014 (in or outside of California) and pursue an associates or bachelors degree.</p>
						<!--- <cfoutput>
							<cfif ListFind(pbsRegions, county.getRegion_ID()) gt 0>
								<!--- pbs region --->
								<p>By attending a Cash for College workshop and completing this exit survey, high school seniors could qualify for a $1,000 scholarship provided by ECMC, or a new $2,000 Performance Based Scholarship provided by College Access Foundation of California. At least one qualifying student from each qualifying workshop who has completed the 2013-14 FAFSA or 2013-14 CA Dream Act Application, and submitted a verified Cal Grant GPA by the March 2 Cal Grant deadline will be randomly selected to receive a scholarship. At least one scholarship per qualifying workshop will be awarded in late April or May, 2013. To claim the scholarship, recipients must attend a qualifying accredited, 2-year or 4-year degree granting institution of their choice in the Fall of 2013 (in or outside of California) and pursue an associates or bachelors degree.</p>
							<cfelse>
								<!--- non pbs region --->
								<p>By attending a Cash for College workshop and completing this exit survey, high school seniors could qualify for a $1,000 scholarship provided by ECMC. At least one qualifying student from each qualifying workshop who has completed the 2013-14 FAFSA or 2013-14 CA Dream Act Application, and submitted a verified Cal Grant GPA by the March 2 Cal Grant deadline will be randomly selected to receive a scholarship. At least one scholarship per qualifying workshop will be awarded in May 2013. To claim the scholarship, recipients must attend a qualifying, accredited, 2-year or 4-year degree granting institution of their choice in the Fall of 2013 (in or outside of California) and pursue an associates or bachelors degree.</p> 

							</cfif>
						</cfoutput> --->
					</div>
				</div>
				<cfform name="studentForm" action="#script_name#" method="post" onsubmit="return validate();" autcomplete="off">
					<cfinput type="hidden" name="workshopID" value="#workshop.getWorkshop_ID()#" />
					<cfinput type="hidden" name="mode" value="#mode#" />
					<cfinput type="hidden" name="Student_ID" value="0" />
					<cfinput type="hidden" name="Workshop_ID" value="#workshop.getWorkshop_ID()#" />
					<cfinput type="hidden" name="action" value="saveStudentEvaluation" />
					<cfinput type="hidden" name="evaluationWDDX" value="#evaluationWDDX#" />
					<cfinput type="hidden" name="Origin" value="Web" />
					<div class="row-fluid">
						<div class="span12">
							<h3>Your Contact Information</h3>
							<div class="row-fluid">
								<div class="span4">
									<div class="q">
										<label class="required">First Name</label>
										<cfinput type="text" maxlength="50" name="First_Name" required="yes" message="First Name is required" class="disableAutoComplete span9" autcomplete="off">
									</div>
									<div class="q">
										<label class="required">Last Name</label>
										<cfinput type="text" maxlength="50" name="Last_Name" required="yes" message="Last Name is required" class="disableAutoComplete span9" autcomplete="off">
									</div>
									<div class="q">
										<label class="required">Home Address</label>
										<cfinput type="text" maxlength="200" name="Address" required="Yes" message="Home Address is required" class="disableAutoComplete span9" autcomplete="off">
									</div>
									<div class="q">
										<label class="required">City</label>
										<cfselect name="City" size="1" required="yes" message="City is required" class="span9">
											<option value="">Select...</option>
											<cfoutput query="cities">
												<cfset name = reReplace(city, "'", "&##027;", "ALL")>
												<option value="#name#">#name#</option>
											</cfoutput>
										</cfselect>
									</div>
									<div class="q">
										<label class="required">Zip Code</label>
										<cfinput type="text" maxlength="5" name="Zip_Code" required="Yes" validate="zipcode" message="Zip Code is required and must be a valid zip code" class="disableAutoComplete span9" autcomplete="off">
									</div>
									
								</div>
								<div class="span4">
									<div class="q">
										<label>Phone 1</label>
										<cfinput type="text" name="Phone1" placeholder="######-######-########" validate="telephone" message="Phone 1 must be in ######-######-######## format" class="disableAutoComplete span9" autocomplete="off">
									</div>
									<div class="q">
										<label>Phone 2</label>
										<cfinput type="text" name="Phone2" placeholder="######-######-########" validate="telephone" message="Phone 2 must be in ######-######-######## format" class="disableAutoComplete span9" autocomplete="off">
									</div>
									<div class="q">
										<label>E-mail</label>
										<cfinput type="text" maxlength="200" name="Email" validate="email" message="E-mail must be a valid e-mail address" class="disableAutoComplete span9" autcomplete="off">
									</div>
								</div>
								<div class="span4">
									<div class="q">
										<label class="required">Date of Birth</label>
										<cfinput type="text" maxlength="200" id="dob" name="DOB" placeholder="m/d/yyyy" required="yes" validate="date" message="Date of Birth is required and must be a valid date" class="disableAutoComplete span9" autcomplete="off">
									</div>
									<div class="q">
										<label class="required">Social Security Number</label>
										<label class="radio">
											<cfinput type="radio" id="ssnCode1" name="SSN_Code" value="1" onclick="checkSSN();" checked="yes"> 
											I have an SSN
										</label>
										<label class="radio">
											<cfinput type="radio" id="ssnCode4" name="SSN_Code" value="4" onclick="checkSSN();">
											I have a DACA SSN
										</label>
										Last 4 digits of your SSN or DACA SSN: <cfinput id="ssn" name="SSN" type="text" validate="integer" placeholder="########" maxlength="4" class="disableAutoComplete span2">
										<label class="radio">
											<cfinput type="radio" id="ssnCode2" name="SSN_Code" value="2" onclick="checkSSN();"> 
											I do not have an SSN
										</label>
										<label class="radio">
											<cfinput type="radio" id="ssnCode3" name="SSN_Code" value="3" onclick="checkSSN();">
											I don't remember my SSN
										</label>
									</div>
								</div>
							</div>
						</div>
					</div>
					<!--- <div class="row-fluid">
						<div class="span12">
						
							<h3>An Alternate Contact (optional)</h3>
							
							<div class="row-fluid">
								<div class="span4">
							
									<div class="q">
										<label>First Name</label>
										<cfinput type="text" name="First_Name_Alt1" class="disableAutoComplete span9" maxlength="50" autcomplete="off">
									</div>
									<div class="q">
										<label>Last Name</label>
										<cfinput type="text" name="Last_Name_Alt1" class="disableAutoComplete span9" maxlength="50" autcomplete="off">
									</div>
									
									<div class="q">
										<label>Home Address</label>
										<cfinput type="text" name="Address_Alt1" class="disableAutoComplete span9" maxlength="200" autcomplete="off">
									</div>
									<div class="q">
										<label>City</label>
										<cfselect name="City_Alt1" size="1" class="span9">
											<option value="">Select...</option>
											<cfoutput query="cities">
												<cfset name = reReplace(city, "'", "&##027;", "ALL")>
												<option value="#name#">#name#</option>
											</cfoutput>
										</cfselect>
									</div>
									<div class="q">
										<label>Zip Code</label>
										<cfinput type="text" maxlength="20" name="Zip_Code_Alt1" validate="zipcode" message="Alternate Contact Zip Code must be a valid zip code" class="disableAutoComplete span9" autcomplete="off">
									</div>
									
								</div>
								<div class="span4">
								
									<div class="q">
										<label>Phone</label>
										<cfinput type="text" name="Phone_Alt1" validate="telephone" message="Alternate Contact Phone must be in ######-######-######## format" class="disableAutoComplete span9" autcomplete="off">
									</div>
									<div class="q">
										<label>E-mail</label>
										<cfinput type="text" name="Email_Alt1" validate="email" message="Alternate Contact must be a valid e-mail address" class="disableAutoComplete span9" maxlength="200" autcomplete="off">
									</div>
									
								</div>
								<div class="span4"></div>
							</div>
						</div>
					</div> --->
					<p><cfinput type="submit" name="submit" value="Finish" class="btn btn-primary btn-large"></p>
				</cfform>
			</cfcase>
			<cfcase value="thankYou">
				<div class="row-fluid">
					<div class="span12">
						<h2>Exit Survey</h2>
						<p><strong>Thank you!  Your exit survey has been saved.</strong></p>
						<p>Please close this window by clicking the small blue &quot;close&quot; button at the bottom of the window.</p>
					</div>
				</div>
			</cfcase>
			<cfcase value="error">
				<div class="row-fluid">
					<div class="span12">
						<h2>Error</h2>
						<p><strong>We are sorry but your submission errored.</strong></p>
						<p>Please find a workshop representative and show him/her this screen.</p>
						<p>Workshop representative, please call the developer at 916-776-6650.</p>
					</div>
				</div>
			</cfcase>
		</cfswitch>
	</div>
	<!--- disable autocomplete, convert to jQuery --->
	<script language="JavaScript" type="text/javascript">
	<!--
		if (document.getElementsByTagName) { 
			var inputElements = document.getElementsByTagName("input"); 
			for (var i = 0; inputElements[i]; i++) { 
				if (inputElements[i].className && (inputElements[i].className.indexOf("disableAutoComplete") != -1)) { 
					inputElements[i].setAttribute("autocomplete","off"); 
				}
			}
		}
	//-->
	</script>
</body>
</html>